ICD-10 compliance: Are You Behind?


ICD-10_Compliance Accurate coding for completed medical procedures impacts reimbursements from insurers. In an attempt to reduce errors and improve the level of documentation on completed procedures, healthcare providers must switch to an updated coding process, moving from ICD-9 to ICD-10. Learning how to prepare for ICD-10 can be a challenge. Many providers have fallen behind schedule for the recommended timeline, and according to a survey conducted by Workgroup for Electronic Data Interchange, four out of five providers will not be in a position to begin testing the new coding process by the new year. At Healthcare Information Services, we help providers get back on track and implement the highest accuracy standards for billing and coding.

What is ICD-10?

Before learning how to prepare for ICD-10, you need to understand some of the differences between the new coding process and the traditional ICD-9 process. Under ICD-9, codes did not differentiate laterality meaning between right and left, so had to have modifiers attached. Otherwise, a patient treated for a broken arm, who then suffered a break on the opposite side, could look like a duplicate billing potentially. New ICD-10 coding allows for a distinction between the two sides without any modifier by documenting and coding for laterality. 

When Does the Update Happen?

Given the number of unprepared healthcare providers, the deadline for switching to ICD-10 has been extended several times over the years but is now set to October, 2015. This gives you the extra time you need to update processes and train employees for the new system. The costs for making the switch can be high, unless it is part of an existing service package. At Healthcare Information Services, we have already prepared for the new billing and coding system, allowing our clients the benefit of up-to-date personnel and a time-tested service. 

How to Prepare for ICD-10 with Revenue Cycle Management

Start your preparation early and find a resource such as AAPC, AHIMA and HIS. 

When a practice partners w/ HIS and outsources the management of their revenue cycle (billing, collections, a/r management, etc.) allows you to focus on patient care, without worrying about the expense of employee training and losses from improperly submitted claims. HIS is ready for ICD-10 now and our partnering practices are as well. HIS and our partners will hit the ground running from Day 1 of ICD-10.

Many insurers only offer a 60-day window after services to submit for a claim. Medicare only allows 120 for revised claim submissions after a denial. That can leave you struggling to put together the appropriate documentation.

At Healthcare Information Services, we assign an expert team of certified professional coders to your practice. They follow up with you to explain any missing or needed documentation. Our team will review the documents for completeness and catch any issues, before the claim is submitted to the insurance company. Your coder will also follow up regularly to ensure that claims reimbursements are submitted on time. Instead of investing thousands on internal preparations for ICD-10, working with a third-party service provider can help to ensure a smooth transition to the new system.